Healthcare computer system with intra-room network

ABSTRACT

A hospital bed, patient/nurse call system, and a hospital network are provided. Communication is provided over a packet based communication network.

This application is a continuation of U.S. patent application Ser. No.11/330,021 which was filed Jan. 11, 2006, issued as U.S. Pat. No.7,315,535, which is a continuation of U.S. patent application Ser. No.10/114,682 which was filed Apr. 1, 2002, issued as U.S. Pat. No.7,092,376, and which claimed the benefit of U.S. Provisional ApplicationNo. 60/280,002 which was filed Mar. 30, 2001; each of which are herebyincorporated by reference herein.

BACKGROUND AND SUMMARY OF THE INVENTION

The present invention relates to a hospital bed and networkcommunication system. More particularly, the present invention relatesto a bed in a patient/nurse call system in a hospital network with voicecommunication implemented over message packets via a packet basedcommunication network.

Almost every hospital wing or ward has a patient/nurse call system thatincludes an audio network to allow a patient in a hospital room tocontact and speak with a nurse or staff member at a nurse station.Typically, the patient may activate a “call” signal by depressing abutton on a small housing connected via hardwire to a unit mounted tothe headwall of the patient room. This small housing is generallyreferred to as a pillow speaker, or pillow unit. The headwall unitusually has another wall-mounted call button for easy operation by anurse. Other input mechanisms may include emergency call buttons, codeblue buttons, or bathroom call buttons. Additionally, the audio networkof these call systems may be used for audio monitoring of a hospitalroom from the nurse station during an extreme emergency, such as a code“blue” status.

Hospitals also include emergency signaling devices for notifyinghospital personnel of other types of emergency conditions, such as smokedetectors or a fire alarm. Typically, these devices generate audiosignals to convey audible alarms over a hospital intercom system, whichmay or may to be interconnected with the patient room audio network.Some hospitals also use bed monitoring devices with bed sensors thatindicate bed conditions such as “brakes on,” mattress firmness (forinflatable mattresses), or incontinence.

Historically, the duplicity of call and information systems in hospitalshas complicated the organization, maintenance and effectivedissemination of all of the useful information that is generated. Ifthese systems cannot be operated in a simple, user-friendly manner, theycan add to the stress level of nurses and staff. As a result, their jobsare made more difficult, rather than made easier. Additionally, use ofmultiple call and information systems in a hospital adds to the costs ofhealth care, due to costs associated with purchase, installation andmaintenance of the various components of these multiple systems, alongwith training personnel how to use the system.

U.S. Pat. Nos. 5,561,412, 5,699,038, and 5,838,223, which areincorporated herein by reference, disclose integration of call andinformation systems through a private branch exchange (“PBX”) voice/dataswitching system that establishes audio links and data distributionbetween a master station and other stations. The disclosedcommunications networks are basically telephone networks that providesynchronous, full duplex, voice and data communications. Additionally,non-voice information signals from emergency signaling devices, bedmonitoring devices, locating and tracking transmitters, and/or variousother pieces of equipment are converted to digital data and transmittedthrough the PBX to the distant end over a low-speed channel.

Although PBX based systems provide several advantages over historicalapproaches, there are still needs to reduce equipment and maintenancecosts, to increase expandability and versatility, and to increase theeffective bandwidth of patient/nurse call systems in hospital networks.

The present invention fulfills the above needs, among others, byproviding a system and method for a hospital bed, a patient/nurse call,and a hospital network using voice and data over packet implementation.

In one illustrated embodiment of the present invention, a patient/nursecall system comprises a plurality of transmitters adapted to be carriedby hospital personnel, each transmitter being configured to periodicallytransmit an identification signal unique to that transmitter, aplurality of patient locations, each of the plurality of patientlocations being associated with a patient and including a receiverconfigured to receive the identification signals from the plurality oftransmitters, and a master station remote from the patient locations,the master station being configured to receive signals from thereceivers to indicate locations of the hospital personnel. The systemalso comprises a packet based communication network, and a plurality offirst audio stations coupled to the packet based communication network.A first audio station is located at each patient location and isidentified by a unique address. Each first audio station includes afirst processor, a first microphone, a first speaker, and a firstconverter configured to receive audio signals from the first microphone,to generate voice data in a packet based data stream correspondingthereto, and to transmit the packet based data stream over thecommunication network. The first converter also is configured to receivea packet based data stream from the communication network, to generateaudio signals corresponding thereto, and to transmit the audio signalsto the first speaker. The system further comprises a second audiostation located at the master station and coupled to the packet basedcommunication network. The second audio station is identified by aunique address and includes a second processor, a second microphone, asecond speaker, and a second converter configured to receive audiosignals from the second microphone, to generate voice data in a packetbased data stream corresponding thereto, and to transmit the packetbased data stream over the communication network. The second converteralso is configured to receive a packet based data stream from thecommunication network, to generate audio signals corresponding thereto,and to transmit the audio signals to the second speaker, therebypermitting audio communication between personnel located at the firstand second audio stations.

In an illustrated embodiment, a server is coupled to the packet basedcommunication network. The server is configured to instruct theplurality of first audio stations to send the packet based data streamto and receive the packet based data stream from the second audiostation. The server is further configured to instruct the second audiostation to send the packet based data stream to and receive the packetbased data stream from the first audio stations.

In another illustrated embodiment of the present invention, apatient/nurse call system comprises a packet based communicationnetwork, a plurality of transmitters, each of the transmitters beingconfigured to be carried by a hospital caregiver and to periodicallytransmit an identification signal that identifies the transmitters and aplurality of receivers configured to receive the identification signalsand generate identification data corresponding thereto. The receiversare configured to convert the identification data into a packet baseddata stream and to transmit the packet based data stream over thecommunication network. The system also includes a first audio stationcoupled to the packet based communication network and being identifiedby a unique address. The first audio station includes a first processor,a first microphone, a first speaker, and a first converter configured toreceive audio signals from the first microphone, to generate voice datain a packet based data stream corresponding thereto, and to transmit thepacket based data stream over the communication network. The firstconverter also is configured to receive a packet based data stream fromthe communication network, to generate audio signals correspondingthereto, and to transmit the audio signals to the first speaker. Thesystem further includes a second audio station coupled to the packetbased communication network and being identified by a unique address.The second audio station includes a second processor, a secondmicrophone, a second speaker, and a second converter configured toreceive audio signals from the second microphone, to generate voice datain a packet based data stream corresponding thereto, and to transmit thepacket based data stream over the communication network. The secondconverter also is configured to receive a packet based data stream fromthe communication network, to generate audio signals correspondingthereto, and to transmit the audio signals to the second speaker. Thesystem still further includes a server coupled to the receivers, thefirst audio station, and the second audio station via the packet basedcommunication network. The server is configured to instruct the firstaudio station and the second audio station regarding at least one ofestablishing an audio connection and terminating an audio connectionbased at least in part on the identification data, thereby permittingaudio communication between personnel located at the first and secondaudio stations.

In the illustrated embodiment, the receiver is further configured togenerate location data based at least in part on the identificationsignals, and the server is further configured to instruct the firstaudio station and the second audio station regarding at least one ofestablishing an audio connection and terminating an audio connectionbased at least in part on the location data.

In yet another illustrated embodiment of the present invention, a methodfor patient and nurse communication over a hospital network comprisesthe steps of receiving at least one of an identification signal from atransmitter carried by a hospital caregiver, a bed status signal, achair call signal, a shower status signal, and a remote code signal,generating non-voice data corresponding to the received signal, andgenerating voice data. The method also includes sending a firstnotification packet from a first address into a packet network, sendinga first request packet from a second address into the packet network inresponse to the first notification packet, transporting the non-voicedata in packets between the first address and the second address inresponse to the first notification packet and the first request packet,and transporting the voice data in packets between the first address andthe second address in response to the first notification packet and thefirst request packet.

In a further illustrated embodiment of the present invention, a patientsupport apparatus comprises a patient support, and a computer coupled tothe patient support. The computer provides an audio station on thepatient support configured to communicate with a packet basedcommunication network. A display coupled to the computer. A data deviceis also coupled to the computer. The data device includes at least oneof a psychological monitor, a treatment device, and a therapy device,the computer being configured to receive data from the data device,convert the data received from the data device to a packet based datastream, and transmit the packet based data stream to the packet basedcommunication network.

In an illustrated embodiment, a plurality of data devices are coupled tothe computer including an input device to input data and instructionsconcerning the patient, and a sensing device including at least one of aheart rate sensor, a respiratory rate sensor, a neurological monitoringsensor, and a temperature sensor. Also in illustrated embodiments, thedata device includes at least one of a vital signs monitor, an IV pump,a ventilator, a defibrillator, and a compression boot. In illustratedembodiments, the patient support is a hospital bed or a patient assistcart.

Additional features of the invention will become apparent to thoseskilled in the art upon consideration of the following detaileddescription of the drawings exemplifying the best mode of carrying outthe invention as presently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustrative architecture of a system for transmittingvoice and data in packets over a network;

FIG. 2 is an illustrative system architecture interconnecting two audiostations and a server computer;

FIG. 3 is an illustrative flow diagram for a process of voice overpacket communication between the two audio stations in the systemillustrated in FIG. 2;

FIG. 4 is an illustrative system architecture interconnecting multipleaudio stations, a server computer, and a server audio station;

FIG. 5 is an illustrative flow diagram of a first process of voice overpacket paging for the system illustrated in FIG. 4;

FIG. 6 is an illustrative flow diagram of a second process of voice overpacket paging for the system illustrated in FIG. 4;

FIG. 7 is an illustrative system architecture that interconnectsmultiple audio stations, multiple server computers, and multiple serveraudio stations through a traffic management device;

FIG. 8 is an illustrative flow diagram describing a process for voiceover packet communication in the system illustrated in FIG. 7;

FIG. 9 describes an illustrative prioritization scheme used to improvequality of service; and

FIG. 10 illustrates an arrangement in which various signaling equipmentis coupled to data devices within the system architecture of FIG. 1.

DETAILED DESCRIPTION OF THE DRAWINGS

Transmitting voice data and/or non-voice data in packets over a networkrequires that a protocol be selected and implemented. Protocols specifymethods for encoding, packetizing, and decoding voice signals as well asfor call signaling, controlling, and packet exchange. Several competingprotocols have been developed. The leading protocol to date is H.323developed by the International Telecommunications Union. (ITU). Anotherprotocol is Session Initiation Protocol (SIP) developed by the InternetEngineering Task Force (IETF). Media Gateway Control Protocol (MGCP) andMegaco are two others. Most protocols are suitable for transmission ofvoice over an Internet Protocol (IP) network. However, some protocolswill also support voice over an Asynchronous Transfer Mode (ATM)network. In any event, one of ordinary skill in the art will readilyappreciate that a number of well known protocols may be used inalternative embodiments of the present invention.

FIG. 1 is an illustrative architecture of a system 100 for transmittingvoice and data in packets over a network. The system 100 includes anysuitable number of intra-room networks 110. Each intra-room network 110couples a number of data devices 120 to an audio station 130 (discussedin further detail below). For example, U.S. Pat. Nos. 5,561,412;5,699,038; and 5,838,223 (which have been incorporated herein byreference) disclose similar intra-room networks. Each data device 120 issuitably configured to receive inputs from various hospital beds,patient/nurse call systems, and/or personnel and asset locating andtracking systems and to communicate the corresponding information to therespective audio station 130.

Each audio station 130 (discussed in further detail below) couples therespective intra-room network 110 to a packet based network 140. In theexemplary embodiment, the packet based network is configured in a“client/server” (or “two-tier”) architecture. In a typical client/serverarchitecture, each computer or process of a system is viewed as either a“client” or a “server.” Generally, a server manages network resourcessuch as file storage, printing operations, database queries, networkcommunications, etc. To enhance efficiency, various servers may bededicated to the management of various different resources. For example,a computer that provides (i.e., “serves up”) Internet access issometimes referred to as a “web server.” A client generally provides auser interface and often provides additional processing power remotefrom the server. Typically, clients can share files and programs amongstthemselves as well as retrieve data from the server(s). In any event,the packet based network 140 may be any suitable collection of devicesthat is connected to share information in packets. To this end, itshould be readily appreciated that the packet based network 140 mayinclude multiple Local Area Networks (“LANs”) and/or Wide Area Networks(“WANs”) that are operably coupled to one another via routers, switches,hubs, gateways, proxies, and/or firewalls (not shown). However, althoughthe exemplary network 140 is implemented in a client/serverarchitecture, it is noted that alternative embodiments may beimplemented in a peer-to-peer architecture or any other suitableconfiguration.

In general, in the exemplary client/server architecture (noted above)each audio station 130 is configured to operate as a client on thepacket based network 140. Accordingly, each exemplary audio station 130is illustratively implemented with a personal computer system, a desktopcomputer system, and/or a workstation manufactured by Dell ComputerCorporation of Round Rock, Tex., Gateway, Inc. of San Diego, Calif., orCompaq Computer Corporation of Houston, Tex. It should be appreciatedthat each audio station 130 may alternatively, or in addition, include anetwork appliance and/or any other suitable packet based network enableddevice.

Additionally, each audio station 130 includes a microphone (not shown)that provides an analog signal to a code-decode (“CODEC”) integratedcircuit (“IC”) (not shown). The CODEC periodically samples the analogvoice signal and generates numerical values representing the amplitudesof the signal at the sample times. The sampling is done a rate highenough to ensure the voice can be recreated with good quality byequipment located at a remote or distant end of the system, such as, forexample, another of the audio stations 130 or a server computer 150 thatis coupled to the packet based network 140. Each audio station 130further includes a speaker (not shown) and a digital-to-analog (“D/A”)converter (not shown). The D/A receives numerical values representingaudio signals and generates corresponding analog signals, which drivethe speaker.

Each audio station has an address that identifies it on the packet basednetwork 140. To transmit data, an audio station 130 builds digitalsignals into a message packet along with all the header information suchas source address, destination address, checksum, packet size, etc. Eachmessage is transmitted onto the network and is addressed to anotheraudio station at the distant end. For voice data, the distant endstation converts the digital signal to analog for sounding through itsspeaker. To ensure good voice quality, packets are consistentlydelivered to the distant end at a rate as fast as they are sampled atthe originating audio station 130. It should be readily appreciated thatany suitable number of similarly configured audio stations 130 and/orother devices may be coupled to the packet based network 140 toeffectuate the communication of voice and other information as discussedin further detail below.

The server computer 150 is configured to provide server operations forthe packet based network 140. To this end, the exemplary server computer140 is illustratively implemented with a server computer systemmanufactured by Dell Computer Corporation of Round Rock, Tex., Gateway,Inc. of San Diego, Calif., or Compaq Computer Corporation of Houston,Tex. Further, the server computing device 140 may alternatively, or inaddition, include network server appliances, server farms, serverclusters, network accessible storage devices, and/or any other devicesuitable for executing operations according to the present invention.The server computer 150 is further configured to code and decode voicesignals and data in a similar manner to the audio station 130.

It should be readily appreciated that any suitable number of packetbased devices (such as, for example, client computer 160,Admission/Discharge/Transfer system (“ADT”) gateway 170, and/or webserver 180, etc.) may be coupled to the packet based network 140 toeffectuate packet based communication of any suitable information intoor out of the packet based network 140 in a manner which is well known.Furthermore, it should be appreciated that such additional packet baseddevices may in turn be suitably coupled to other networks (such as, forexample, hospital information system network 190, etc.), which may inturn be suitably coupled to their own respective databases (such as, forexample, ADT database 200, etc.) and/or their respective user interfaces(such as, for example, ADT hospital users 210, etc.).

FIG. 2 is an illustrative system architecture 300 interconnecting twoaudio stations 130 ₁, 130 ₂ and a server computer 150 ₁ with a packetbased network 140 ₁. Exemplary audio station 130 ₁, exemplary audiostation 130 ₂, exemplary server computer 150 ₁, and exemplary packetbased network 140 ₁ are implemented in similar manners to audiostation(s) 130, server computer 150, and packet based network 140,respectively (discussed above in connection with FIG. 1). FIG. 3 is anillustrative flow diagram for a process 400 of voice over packetcommunication between the two audio stations 130 ₁, 130 ₂ in the systemillustrated in FIG. 2.

At step 410, audio station 130 ₁ initiates a call. It should beappreciated that the call may be in response to a user input (forexample, actuation of a call button by a caregiver or a patient) or anautomatic signal from monitoring equipment that is provided to audiostation 130 ₁ by a data device (see FIG. 1).

Upon initiation of the call, audio station 130 ₁ sends a message overnetwork 140 ₁ to server computer 150 ₁ (step 420). Server computer 150 ₁displays this call information on a user terminal and also searches adatabase to determine which patient room the call is from and whatcaregiver is assigned to that patient. If a caregiver at audio station1302 wants to answer the call, then that caregiver inputs a request intoaudio station 130 ₂ to answer the call through a suitable user interfaceand/or data device. In response to the request to answer the call, atstep 430 audio station 130 ₂ sends a request to server computer 150 ₁for permission to establish an audio connection with station audiostation 130 ₁.

At step 440, server computer 150 ₁ determines whether the caregiver ataudio station 130 ₂ should have permission to take the call. It shouldbe appreciated that server computer 150 ₁ may make this determinationbased on predetermined software logic which may consider inputs fromother system users (such as, for example, a head or “charge” nurse whois provided an indication of the call request status by server computer150 ₁ or any other manager or supervisor), which may alternatively or inaddition consider location and/or tracking information from a datadevice(s) that indicates the identity and whereabouts of the caregiverwho is requesting to answer the call (see FIG. 10), and/or which mayconsider any other suitable inputs or variables.

If the server computer 150 ₁ determines at step 440 that permission notgranted for the caregiver at audio station 130 ₂ to answer the call,then at step 450 server computer 150 ₁ sends a message to audio station130 ₂ indicating a denial of the request to answer the call and theserver computer 150 ₁ terminates the process 400.

If the server computer 150 ₁ determines at step 440 that permissiongranted for the caregiver at audio station 130 ₂ to answer the call,then server computer 150 ₁ bypasses step 450 and at step 460 the servercomputer 150 ₁ sends a message(s) over network 140 ₁ to audio stations130 ₁, 130 ₂ that instructs them to transmit their voice packets to eachother over the network 140 ₁, thereby establishing a voice connection.At step 470, audio stations 130 ₁, 130 ₂ build their voice data intomessage packets (i.e., they “packetize” the voice data) in response tothe instruction(s) from server computer 150 ₁ to transmit voice packets,and they transmit the packets between each other.

At step 480, the caregiver at audio stations 130 ₂ initiates a requestto end the audio connection (or to “hang up”). It is noted that therequest to end the call may include an active request (such as, forexample, actuation of a “voice end” button), and in alternativeembodiments may in addition or alternatively include a passive request(such as, for example, a locating and tracking detection that thecaregiver has left a proximity of the audio stations 130 ₂). In responseto the request to end the audio connection, audio station 130 ₂ sends amessage to server computer 140 ₁ that requests termination of the audioconnection. In response to the request to termination the audioconnection generated at step 480, at step 490 server computer 150 ₁sends a message to both audio stations 130 ₁, 130 ₂ that instructs themto stop their voice transmissions, thereby terminating the audioconnection.

Next, FIG. 4 is an illustrative system architecture 500 interconnectingmultiple audio stations 130 ₃, 130 ₄, 130 ₅, 130 ₆, a server computer150 ₂, and a server audio station 150 ₃. This exemplary embodimentprovides a paging feature. Paging consists of transmitting voice fromone audio station to one or more additional audio stations in onedirection only. It should be appreciated that exemplary audio stations130 ₃, 130 ₄, 130 ₅, 130 ₆, exemplary server computer 150 ₂, andexemplary packet based network 1402 are implemented in similar mannersto audio station(s) 130, server computer 150, and packet based network140, respectively (discussed above in connection with FIG. 1); andexemplary server audio station 150 ₃ is implemented in a similar mannerto server computer 150 (with suitable software and/or hardwaremodifications to perform the relevant operations discussed herein).

FIG. 5 is an illustrative flow diagram of a first process 600 of voiceover packet paging for the system illustrated in FIG. 4. To send a page,at step 610 a user inputs a request to server computer 150 ₂ to initiatea selected page to desired audio stations. The discussion that followsin connection with FIG. 5 assumes (as an example) that audio stations130 ₃, 130 ₄, 130 ₅ are selected. At step 620, server computer 150 ₂sends instructions to the selected audio stations (the “page group”) toreceive voice broadcast (page) packets and generate corresponding soundsvia their speakers. It is noted that any audio stations not selected donot receive such instructions (see step 630).

At step 640, server computer 150 ₂ sends instructions to server audiostation 150 ₃ to begin broadcasting the selected page in voice datapackets. The page is broadcast suitably repeatedly until the userterminates the page (see step 650).

At step 650, the user inputs a request to terminate the page (or to“hang up”) into server computer 150 ₂. The request to end the page mayinclude an active request (such as, for example, actuation of a “pageend” button), and in alternative embodiments may in addition oralternatively include a passive request (such as, for example, alocating and tracking detection that the user has left a proximity ofthe server computer 150 ₂).

At step 660, the server computer 150 ₂ sends instructions to thepreviously selected audio stations (see step 620, above) to stopsounding voice broadcast (page) packets. At step 670, server computer150 ₂ sends instructions to server audio station 150 ₃ to stopbroadcasting the voice packets.

FIG. 6 is an illustrative flow diagram of a second process 700 of voiceover packet paging for the system illustrated in FIG. 4. To send a pageusing the process 700, at step 710 a user inputs a request to servercomputer 150 ₂ to initiate a selected page to desired audio stations.The discussion that follows in connection with FIG. 6 assumes (as anexample) that audio stations 130 ₃, 130 ₄, 130 ₅ are selected. At step720, server computer 150 ₂ sends instructions to server audio station150 ₃ to transmit the selected page in voice data packets addressedspecifically (and only) to the selected audio stations 150 ₂. At step730, the selected audio stations receive the page packets and producecorresponding audio from their speakers.

At step 740, the user inputs a request to terminate the page (or to“hang up”) into server computer 150 ₂. The request to end the page mayinclude an active request (such as, for example, actuation of a “pageend” button), and in alternative embodiments may in addition oralternatively include a passive request (such as, for example, alocating and tracking detection that the user has left a proximity ofthe server computer 150 ₂). At step 750, server computer 150 ₂ sendsinstructions to server audio station 150 ₃ to stop broadcasting thevoice packets.

FIG. 7 is an illustrative system architecture 800 that interconnectsmultiple audio stations 130 ₇, 130 ₈, 130 ₉, 130 ₁₀, 130 ₁₁, 130 ₁₂, 130₁₃, 130 ₁₄, multiple server computers 150 ₃, 150 ₄, and multiple serveraudio stations 150 ₅, 150 ₆, and multiple packet based networks 140 ₃,140 ₄ through a traffic management device 810. It should be appreciatedthat exemplary audio stations 130 ₇, 130 ₈, 130 ₉, 130 ₁₀, 130 ₁₁, 130₁₂, 130 ₁₃, 130 ₁₄, exemplary server computers 150 ₃, 150 ₄, andexemplary packet based networks 140 ₃, 140 ₄ are implemented in similarmanners to audio station(s) 130, server computer 150, and packet basednetwork 140, respectively (discussed above in connection with FIG. 1),and exemplary server audio stations 150 ₅, 150 ₆, are implemented in asimilar manner to server computer 150 (with suitable software and/orhardware modifications to perform the relevant operations discussedherein).

When the number of networked devices increases, the amount of networktraffic also increases. To increase efficiencies, the network is brokeninto smaller segments and the segments are interconnected usingintelligent devices that manage the traffic between the segments. Tothis end, the traffic management device 810 suitably includes bridges,switches, routers, and other known devices. In a manner that is wellknown, the traffic management device dynamically “learns” the addressesof the devices on each network segment and manages communicationsbetween the network segments.

FIG. 8 is an illustrative flow diagram describing a process 900 forvoice over packet communication in the system illustrated in FIG. 7. Ingeneral, the traffic management devices look at the source anddestination of each packet transmitted on the network to determine ifthe packet is destined for a device on a segment different than thesource. If so, the traffic management device retransmits the packet ontothe appropriate network segment. This method reduces traffic on eachsegment to only packets transmitted or received by devices on thatsegment.

More particularly, at step 910 a user places a call (i.e., seeks toinitiate an audio connection) through one of the audio stations (audiostation 130 ₇, for example). At step 920, the calling audio stationsends a message to the server computer that is on its network segment(in this example, the message is sent to server computer 150 ₃ overpacket based network 140 ₃) indicating that the calling audio stationhas requested an audio connection, and that server computer sendsmessage(s) over the network indicating that the calling audio stationhas placed the call. Further, the traffic management device relays theindication that the calling audio station has requested an audioconnection to the distant network segment (in this example, packet basednetwork 140 ₄). At step 930, a user at a distant audio station (in thisexample, audio station 130 ₁₃) indicates a request to answer the call.Accordingly, the distant audio station sends a request for permission toanswer the call to the server computer on its network segment (in thisexample, to server computer 150 ₄ over packet based network 140 ₄). Atstep 940, the server computer on the network segment that is distantfrom the caller (i.e., server computer 150 ₄ in this example) transmitsthe request for permission to answer the call over its respectivenetwork segment.

At step 950, the traffic management device 810 determines that themessage packets indicating the request for permission to answer the callare addressed to the server computer that is on the same network segmentas the caller, and, accordingly, the traffic management device relaysthe packets onto the network segment of the caller. At step 960, theserver computer on the network segment of the caller (i.e., the“proximate server”) determines whether the distant audio station thathas requested permission to answer the call should have permission toanswer the call. If so, then the proximate server computer proceeds tostep 980; otherwise, the proximate server computer sends a message tothe distant audio station that has requested the permission indicatingthat the request to answer the call is denied (step 970) and theremaining steps are bypassed.

At step 980, the proximate server computer transmits a message onto itsnetwork segment indicating approval of the distant audio station'srequest for permission to answer the call. At step 990, the trafficmanagement device 810 determines that the packets transmitted by theproximate server computer (step 980) are addressed to a device on thedistant network segment and, accordingly, relays the packets to thedistant segment.

At step 1000, the proximate server computer sends a message to the audiostation that initiated the call and the distant server computer sends amessage to the audio station that has requested permission to receivethe call, and in response these two audio stations begin transmittingvoice data packets between them. At step 1010, the traffic managementdevice 810 determines that the streaming packets are addressed to audiostations on different network segments and relays the packets betweenthe segments as appropriate. The audio stations sound the correspondingaudio on their speakers.

At step 1020, the user who answered the call inputs a request toterminate the audio connection (or to “hang up”) into the servercomputer on its network segment. The request to end the call may includean active request (such as, for example, actuation of a “call end”button), and in alternative embodiments may in addition or alternativelyinclude a passive request (such as, for example, a locating and trackingdetection that the user has left a proximity of the server computer fromwhich the user answered the call). At step 1030, the proximate servercomputer sends a message to the audio station that initiated the calland the distant server computer sends a message to the audio stationthat received the call, and in response the two audio stations stoptransmitting voice data packets between them.

Next, FIG. 9 shows an illustrative prioritization scheme 1100 forimproving quality of service (i.e., “voice quality,” or “QOS”). Whentransmitting voice over a packet network, increased bandwidth for theduration of the audio connection is one way to ensure good quality,real-time voice communication. Most telephony systems have historicallydedicated a channel for each voice connection in order to guaranteebandwidth. However, when sending voice in packets over an asynchronousnetwork, guaranteeing bandwidth is much more difficult. This isespecially true when the network is also supporting numerous other voiceand data applications.

Several methods have been employed to deal with the problem of voicequality of service. One solution has been to move to higher speednetworks. Another is to design networks that provide multiple pathsthrough which packets can travel. Yet another is to use routers andswitches that provide quality of service features. Devices with thesefeatures are able to recognize the type of each packet it is processing.These devices can then give voice packets a priority over other packettypes so that they are processed sooner. Illustratively, some routersand switches will purposely introduce delays in the processing of lowerpriority packets to cause the sending devices to slow the rate at whichpackets are sent. This reduces the amount of bandwidth used by lowpriority traffic.

As shown in FIG. 9, a server computer categorizes the types of trafficon the network into levels of priority to be postponed and/or throttledback to free bandwidth for voice traffic depending on the priority leveland then number of simultaneous voice connections. If a voice connectionis established, low priority traffic such as messages related to changesin the location of equipment, is postponed until the voice connection isterminated. If two voice connections are established, both the lowestpriority and second from lowest priority traffic is postponed.

More particularly, the exemplary embodiment includes five prioritylevels (where “1” indicates the highest and “5” indicates the lowestpriority), as follows:

Priority Information/Data Type 1 calls 2 people movements/tracking 3maintenance 4 routine status updates 5 equipment movements/tracking

Referring still to FIG. 9, when one or more audio connections areestablished, the server computer(s) instruct all audio stations topostpone transmission of priority 5 (equipment movements/tracking)messages; otherwise, the server computer(s) instruct all audio stationsto allow transmission of priority 5 messages.

Additionally, when two or more audio connections are established, theserver computer(s) instruct all audio stations to slow transmission ofpriority 4 (routine status updates) messages to 25% of the full rate;otherwise, the server computer(s) instruct all audio stations to allowtransmission of priority 4 messages at the full rate.

Additionally, when three or more audio connections are established, theserver computer(s) instruct all audio stations to slow transmission ofpriority 3 (maintenance) messages to 50% of the full rate; otherwise,the server computer(s) instruct all audio stations to allow transmissionof priority 3 messages at the full rate.

Additionally, when four or more audio connections are established, theserver computer(s) instruct all audio stations to slow transmission ofpriority 2 (people movements/tracking) messages to 75% of the full rate;otherwise, the server computer(s) instruct all audio stations to allowtransmission of priority 2 messages at the full rate.

Next, FIG. 10 illustrates an arrangement 1200 in which various signalingequipment is coupled to data devices within the system architecture ofFIG. 1. For example, locating and tracking systems that track movementof caregivers and equipment through hospital facilities are known. Somesuch systems include badges that use infrared, radio frequency,ultrasonic, or other types of transmitters that periodically transmitidentification signals. In operation, receivers throughout the facility(not shown) suitably detect the identification information. It is notedthat locating and tracking inputs for the present invention may beimplemented with a COMposer® system or a COMLNX™ system (available fromHill-Rom NetLinx located in Cary, N.C.) or similar system. Further, asillustrated in FIG. 10, one or more data devices 120 ₁ may be configuredto receive identification signals from locating and tracking badges1210, and may be further configured to receive information signals fromvarious other signaling equipment such as chair call devices 1220,pillow speakers 1240, and/or a hospital bed status unit 1230. U.S. Pat.Nos. 5,561,412; 5,699,038; and 5,838,223 (which have been incorporatedherein by reference) disclose the operation of such equipment and,furthermore, suitable alternative signaling equipment is known.Additionally, it is noted that audio station(s) 130 ₁₅ may be combinedor otherwise integrated with the respective data device(s) 120 ₁ and/orany suitable number of the various signaling devices.

In an illustrated embodiment of the present invention, a hospital bed isprovided with an audio station 130 to communicate with the network 140.In this embodiment, the hospital bed itself includes a computer andprovides audio station 130 for communicating voice data and othernon-voice from the hospital bed to the network. In another embodiment ofthe present invention, the audio station 130 is provided on a cart orother device which moves with the patient through the hospital toprovide a patient point of care computer system. Embodiments of acomputer system on a bed or cart are included in U.S. patent applicationSer. No. 09/849,580, filed May 4, 2001 and U.S. Ser. No. 60/310,092,filed Aug. 3, 2001, the disclosures of which are expressly incorporatedby reference herein.

By providing the audio station 130 on the hospital bed or cart, thesystem of the present invention provides network communication from thearea around the patient point of care to the hospital informationnetwork 190 at all times. In other words, when the hospital bed is movedfrom room to room, a network connection is made between the audiostation 130 on the hospital bed and the network 140. Likewise, when thepatient care cart moves with a patient through the facility,communication between the audio station 130 on the patient care cart andthe network 140 is made. Such communication is accomplished through awired connection or a wireless data connection within the hospital.Therefore, the patient and caregiver have improved data and voicecommunication over the network at the patient point of care. Caregivershave access to patient data including video information, and voicecommunication from a remote location to the patient's bedside.Therefore, caregivers can access patient chart information, testresults, etc. from a remote location.

Some of the data devices 120 are illustratively physiological monitors,treatment devices, and therapy devices. A network computer in the room,on the bed, or on a patient cart is coupled to the data device by anRS-232 port or other suitable connector. The computer processes signalsfrom the monitors, treatment devices, and therapy devices on a real timebasis. The monitors, treatment devices, and therapy devices include, butare not limited to, heart rate monitors, temperature sensors, bloodpressure monitors (invasive and noninvasive), EKG monitors, blood oxygensensors, capnographs, ventilators, IV pumps, scales, and chest drainagemonitors. Additional details of the computer and data devices aredisclosed in U.S. patent application Ser. No. 09/849,580, filed May 4,2001, and U.S. patent application Ser. No. U.S. patent application Ser.No. 60/310,092, filed on Aug. 3, 2001, the disclosures of which areincorporated herein by reference.

In another illustrated embodiment, the computer on the bed or cart isused to provide a medication scan, TV, phone, and bed controls, internetaccess, e-mail, music or DVD players, and nurse call. Computer is alsocoupled to a display. Illustratively, display 24 is a touch screendisplay which can be used as both a TV terminal and a computer display.Software provides a keyboard emulation on display to permit a user toinput information to computer using touch screen display. It isunderstood that any conventional input device such as a pen or stylusbased input, a keyboard, a mouse, a joy stick, a voice recognitioninput, or other suitable input device may be used to input informationinto computer.

Although the invention has been described in detail with reference tocertain illustrated embodiments, variations and modifications existwithin the scope and spirit of the present invention as defined in thefollowing claims.

1. A healthcare computer network comprising an intra-room networkincluding a first computer device and a first plurality of data devicescommunicatively coupled to the first computer device, at least one ofthe plurality of data devices comprising a vital signs monitor, a firsthospital bed communicatively coupled to the first computer device of theintra-room network, and a packet based network, the first computerdevice being configured to build digital signals from the firstplurality of data devices and from the first hospital bed into messagepackets that are addressed to a third computer device which is coupledto the packet based network, and a transmitter to be carried by acaregiver, the intra-room network having a receiver configured toreceive a signal from the transmitter and to transmit at least oneidentification packet to the third computer device.
 2. The healthcarecomputer network of claim 1, wherein the first computer device has audiocommunication capability.
 3. The healthcare computer network of claim 2,wherein the first computer device comprises an audio station thatcomprises a microphone, a speaker and a digital-to-analog converter toprovide at least part of the audio communication capability.
 4. Thehealthcare computer network of claim 1, wherein at least another one ofthe first plurality of data devices comprises one of an IV pump, aventilator, a defibrillator, and a compression boot.
 5. The healthcarecomputer network of claim 1, wherein the intra-room network furthercomprises a second plurality of data devices and a second hospital bed.6. The healthcare computer network of claim 5, wherein the firsthospital bed, the second hospital bed, the first plurality of datadevices and the second plurality of data devices are located in a firstpatient room.
 7. The healthcare computer network of claim 5, wherein thesecond plurality of data devices and the second hospital bed arecommunicatively coupled to the first computer device.
 8. The healthcarecomputer network of claim 1, wherein the packet based network comprisesa server configured to manage communication of message packets from thefirst computer device to the third computer device by prioritizing themessage packets from the first computer device.
 9. The healthcarecomputer network of claim 1, wherein the first computer device ismounted to the first hospital bed.
 10. The healthcare computer networkof claim 9, wherein the first computer is configured to serve as anaudio station on the first hospital bed.
 11. The healthcare computernetwork of claim 1, further comprising an Admisstion/Disharge/Transfer(ADT) system having an ADT computer configured to transmit ADT datapackets to the first computer device.
 12. The healthcare computernetwork of claim 1, further comprising an Admisstion/Disharge/Transfer(ADT) system and the third computer device is included in the ADTsystem.
 13. The healthcare computer network of claim 1, furthercomprising a nurse call system having a nurse call computer configuredto transmit audio packets to the first computer device.
 14. Thehealthcare computer network of claim 1, further comprising a nurse callsystem and the third computer device is included in the nurse callsystem.
 15. The healthcare computer network of claim 1, furthercomprising a second intra-room network and the third computer device isincluded in the second intra-room network.
 16. The healthcare computernetwork of claim 15, wherein the message packets comprise voice packets.17. The healthcare computer network of claim 1, wherein at least one ofdata devices of the first plurality of data devices comprises an inputdevice to input data and instructions concerning a patient.
 18. Ahealthcare computer network comprising an intra-room network including afirst computer device and a first plurality of data devicescommunicatively coupled to the first computer device, at least one ofthe plurality of data devices comprising a vital signs monitor, a firsthospital bed communicatively coupled to the first computer device of theintra-room network, and a packet based network, the first computerdevice being configured to build digital signals from the firstplurality of data devices and from the first hospital bed into messagepackets that are addressed to a third computer device which is coupledto the packet based network, wherein the packet based network comprisesa server configured to manage communication of message packets from thefirst computer device to the third computer device by prioritizing themessage packets from the first computer device, wherein the serverdelays sending message packets associated with a lower priority untilprocessing of packets with a higher priority is complete.
 19. Thehealthcare computer network of claim 18, wherein message packetscontaining voice data are associated with a highest priority.
 20. Thehealthcare computer network of claim 18, further comprising atransmitter to be carried by a caregiver and the intra-room networkhaving a receiver configured to receive a signal from the transmitterand to transmit at least one identification packet to the third computerdevice.